I was the Australian doctor on the WHO’s COVID-19 mission to China. Here’s what we found about the origins of the coronavirus


Dominic Dwyer, University of Sydney

As I write, I am in hotel quarantine in Sydney, after returning from Wuhan, China. There, I was the Australian representative on the international World Health Organization’s (WHO) investigation into the origins of the SARS-CoV-2 virus.

Much has been said of the politics surrounding the mission to investigate the viral origins of COVID-19. So it’s easy to forget that behind these investigations are real people.

As part of the mission, we met the man who, on December 8, 2019, was the first confirmed COVID-19 case; he’s since recovered. We met the husband of a doctor who died of COVID-19 and left behind a young child. We met the doctors who worked in the Wuhan hospitals treating those early COVID-19 cases, and learned what happened to them and their colleagues. We witnessed the impact of COVID-19 on many individuals and communities, affected so early in the pandemic, when we didn’t know much about the virus, how it spreads, how to treat COVID-19, or its impacts.

We talked to our Chinese counterparts — scientists, epidemiologists, doctors — over the four weeks the WHO mission was in China. We were in meetings with them for up to 15 hours a day, so we became colleagues, even friends. This allowed us to build respect and trust in a way you couldn’t necessarily do via Zoom or email.

This is what we learned about the origins of SARS-CoV-2.

Animal origins, but not necessarily at the Wuhan markets

It was in Wuhan, in central China, that the virus, now called SARS-CoV-2, emerged in December 2019, unleashing the greatest infectious disease outbreak since the 1918-19 influenza pandemic.

Our investigations concluded the virus was most likely of animal origin. It probably crossed over to humans from bats, via an as-yet-unknown intermediary animal, at an unknown location. Such “zoonotic” diseases have triggered pandemics before. But we are still working to confirm the exact chain of events that led to the current pandemic. Sampling of bats in Hubei province and wildlife across China has revealed no SARS-CoV-2 to date.

We visited the now-closed Wuhan wet market which, in the early days of the pandemic, was blamed as the source of the virus. Some stalls at the market sold “domesticated” wildlife products. These are animals raised for food, such as bamboo rats, civets and ferret badgers. There is also evidence some domesticated wildlife may be susceptible to SARS-CoV-2. However, none of the animal products sampled after the market’s closure tested positive for SARS-CoV-2.

We also know not all of those first 174 early COVID-19 cases visited the market, including the man who was diagnosed in December 2019 with the earliest onset date.

However, when we visited the closed market, it’s easy to see how an infection might have spread there. When it was open, there would have been around 10,000 people visiting a day, in close proximity, with poor ventilation and drainage.

There’s also genetic evidence generated during the mission for a transmission cluster there. Viral sequences from several of the market cases were identical, suggesting a transmission cluster. However, there was some diversity in other viral sequences, implying other unknown or unsampled chains of transmission.

A summary of modelling studies of the time to the most recent common ancestor of SARS-CoV-2 sequences estimated the start of the pandemic between mid-November and early December. There are also publications suggesting SARS-CoV-2 circulation in various countries earlier than the first case in Wuhan, although these require confirmation.

The market in Wuhan, in the end, was more of an amplifying event rather than necessarily a true ground zero. So we need to look elsewhere for the viral origins.




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Frozen or refrigerated food not ruled out in the spread

Then there was the “cold chain” hypothesis. This is the idea the virus might have originated from elsewhere via the farming, catching, processing, transporting, refrigeration or freezing of food. Was that food ice cream, fish, wildlife meat? We don’t know. It’s unproven that this triggered the origin of the virus itself. But to what extent did it contribute to its spread? Again, we don’t know.

Several “cold chain” products present in the Wuhan market were not tested for the virus. Environmental sampling in the market showed viral surface contamination. This may indicate the introduction of SARS-CoV-2 through infected people, or contaminated animal products and “cold chain” products. Investigation of “cold chain” products and virus survival at low temperatures is still underway.




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Extremely unlikely the virus escaped from a lab

The most politically sensitive option we looked at was the virus escaping from a laboratory. We concluded this was extremely unlikely.

We visited the Wuhan Institute of Virology, which is an impressive research facility, and looks to be run well, with due regard to staff health.

We spoke to the scientists there. We heard that scientists’ blood samples, which are routinely taken and stored, were tested for signs they had been infected. No evidence of antibodies to the coronavirus was found. We looked at their biosecurity audits. No evidence.

We looked at the closest virus to SARS-CoV-2 they were working on — the virus RaTG13 — which had been detected in caves in southern China where some miners had died seven years previously.

But all the scientists had was a genetic sequence for this virus. They hadn’t managed to grow it in culture. While viruses certainly do escape from laboratories, this is rare. So, we concluded it was extremely unlikely this had happened in Wuhan.




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A team of investigators

When I say “we”, the mission was a joint exercise between the WHO and the Chinese health commission. In all, there were 17 Chinese and ten international experts, plus seven other experts and support staff from various agencies. We looked at the clinical epidemiology (how COVID-19 spread among people), the molecular epidemiology (the genetic makeup of the virus and its spread), and the role of animals and the environment.

The clinical epidemiology group alone looked at China’s records of 76,000 episodes from more than 200 institutions of anything that could have resembled COVID-19 — such as influenza-like illnesses, pneumonia and other respiratory illnesses. They found no clear evidence of substantial circulation of COVID-19 in Wuhan during the latter part of 2019 before the first case.

Where to now?

Our mission to China was only phase one. We are due to publish our official report in the coming weeks. Investigators will also look further afield for data, to investigate evidence the virus was circulating in Europe, for instance, earlier in 2019. Investigators will continue to test wildlife and other animals in the region for signs of the virus. And we’ll continue to learn from our experiences to improve how we investigate the next pandemic.

Irrespective of the origins of the virus, individual people with the disease are at the beginning of the epidemiology data points, sequences and numbers. The long-term physical and psychological effects — the tragedy and anxiety — will be felt in Wuhan, and elsewhere, for decades to come.




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The Conversation


Dominic Dwyer, Director of Public Health Pathology, NSW Health Pathology, Westmead Hospital and University of Sydney, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How China is remaking the world in its vision


Natasha Kassam, Australian National University and Darren Lim, Australian National University

This is an edited extract of an essay in the latest issue of Australian Foreign Affairs, The March of Autocracy, published today.


It is the year 2049. China is celebrating having reached its second centenary goal – to become a “prosperous, powerful, democratic, civilised and harmonious socialist modernised country” by the 100th anniversary of the people’s republic.

Its economy is three times the size of the United States’, as the International Monetary Fund predicted back in the 2010s. The US remains wealthy and powerful – it has functioning alliances in Europe – but its pacts with Asian allies have fallen into disrepair.

For decades, Hong Kong has been accepted as just another province of China. Few dare to criticise the ongoing human rights abuses there, or in Xinjiang and elsewhere, because of the extraterritorial application of China’s national security laws. Taiwan, if not annexed, is isolated, with no diplomatic partners.

The legacy of Xi Jinping, who led China for more than 30 years, monopolises ideological discourse in China. His successors rule under his shadow.

Outside China, many of the third-wave democracies that transitioned in the second half of the 20th century have become far less liberal. Elections are held, but increasingly authoritarian governments have adopted many of Beijing’s technological and legal tools to manage markets and control politics. The internet is heavily censored.

Mistrust permeates every aspect of China’s relations with the West. International co-operation on climate change and the strong carbon-reduction commitments of the early 2020s have long been abandoned. The focus is on individual adaptation.

Australia remains a liberal democracy and a staunch defender of free markets and human rights. But these are no longer the default standards of global governance – they are minority positions associated mostly with Western traditions. No longer a top-20 economic or military power, Australia’s opportunities to make its mark internationally are few and far between.

An unsettling but plausible vision

This vision of a fragmented and decidedly less liberal international order is highly speculative, but also dispiritingly plausible.

It is unsettling to an Australian reader, not just because Australian foreign policy has been centred on a global set of rules and institutions since 1945, but because Australian identity is so enmeshed with the values of liberal democracy.

The 2017 Foreign Policy White Paper states that Canberra is “a determined advocate of liberal institutions, universal values and human rights”, in stark contrast to Beijing.




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All nation states, especially rising powers, desire a favourable global environment in which they can acquire power, prosperity and prestige. The postwar system greatly aided China, and it would be incorrect to claim Beijing wants to dismantle it entirely.

Similarly, it would be disingenuous to overlook the many instances where the US and other liberal democracies have behaved inconsistently.

But the Chinese Communist Party, which leads an authoritarian state, sees the liberal values embedded in the present order as a threat to its rule. Unlike the US, which at times ignores or violates these principles, China needs many of them to be suppressed, even eliminated.

As China seeks to remake the international order, the challenge is to understand where and how Beijing’s efforts will undercut its liberal character, and to identify where it is possible to resist.

Chinese state media lauded Xi Jinping as a ‘champion of the UN ethos’ ahead of the UN General Assembly last year.
Andy Wong/AP

How China is changing the world

Rather than upend the existing international system, Beijing’s approach today is to co-opt, ignore and selectively exploit institutions.

Xi has said:

reforming and improving the current international system do not mean completely replacing it, but rather advancing it in a direction that is more just and reasonable.

In late 2019, for instance, the World Trade Organisation’s appellate body ceased to function after the US – complaining about the organisation’s soft stance on China – blocked the appointment of replacement judges.

In many ways, the WTO’s structure is the epitome of a liberal rules-based system: countries relinquish some sovereignty and are bound by judicial decisions in the interests of resolving trade disputes.

In response, China joined with the European Union, Australia and other governments to set up a parallel stop-gap legal mechanism.

This was a reflection of the CCP’s nuanced relationship with the liberal international order. China needs a stable trading system and will agree to binding rules to preserve it. The odd trade dispute does not substantially threaten China’s ideological security.

In the future, Beijing should be expected to exert its influence on the current order. The challenge for states such as Australia is to identify when Beijing’s behaviour exceeds influence and begins to erode the system’s liberal foundations.

China is already skilfully manoeuvring within international institutions to guide their operations, press for reforms and promote the China model.

Chinese nationals run four of the 15 United Nations specialised agencies, including the Food and Agricultural Organisation and the International Civil Aviation Organisation.

Qu Dongyu, the new director general of the Food and Agricultural Organisation.
Riccardo Antimiani/AP

Ironically, the democratic nature of international institutions benefits Beijing. Chinese representatives in a variety of forums, such as the World Health Assembly and committees of the UN General Assembly, muster coalitions of the Global South to ensure favourable votes on issues such as Taiwan’s (non)participation or to counter criticism of its repressive policies in Xinjiang.

China also elevates its government-organised NGOs, presenting an image of independence while drowning out the voices of independent civil society.

The China Society for Human Rights Studies, for example, has official consultative status at the United Nations as an NGO, but is co-located with Chinese government offices and staffed by Chinese government officials. It has vigorously prosecuted China’s human rights agenda.




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The use of deft diplomacy and inducements to generate voting blocs is unsurprising. But China also seeks to change the system, diluting the liberal elements that threaten the China model and thus the CCP’s rule.

For instance, China has already succeeded in weakening the liberal character of international human rights. In 2017, it proposed its first-ever resolution to the UN Human Rights Council, headed: “The contribution of development to the enjoyment of all human rights”.

It prioritised economic development above civil and political rights, and put the primacy of the state above the rights of the individual. Despite objections and nay votes from Western members, the resolution passed. The subsequent report by the council’s advisory committee, a body of 18 experts supposed to maintain independence, referred mainly to Chinese party-state documents.

Chinese diplomats also block human rights resolutions at the UN Security Council, such as a February 2020 resolution on the plight of Myanmar’s ethnic Rohingya.

Chinese Foreign Minister Wang Yi speaks during a UN Security Council briefing in 2018.
Evan Vucci/AP

While the US has arguably been similarly obstructive on resolutions about Palestine, it is for the narrow purpose of protecting an ally, rather than the broader project of weakening the rights themselves.

China has even been able to marshal the international system to defend and commend its behaviour in Xinjiang and Hong Kong.

In 2020, at the 44th session of the UN Human Rights Council, a joint statement signed by 27 countries, including Australia, expressed concern at arbitrary detention, widespread surveillance and restrictions in Xinjiang and the national security legislation in Hong Kong.

A competing statement supporting the Hong Kong legislation received support from 53 states, only three of which are considered “free” by the non-governmental organisation Freedom House.

By working within the system to rally a voting bloc, Beijing was able to compromise the world’s peak human rights body. Tactics that have been successful in watering down human rights are now being employed in areas where norms are still being established, such as internet governance.

Preparing for the new world disorder

The history of liberal internationalism is replete with contradictions. Some say that in recent decades it is Washington, not Beijing, that has damaged the order most.

So can China really do more damage to an order already on life support? Liberalism is not just facing an external challenge, but one from within.

The answer requires optimism about liberalism’s capacity to self-correct across the arc of history, and scepticism that illiberalism can do likewise. As much as Donald Trump belittled, criticised and attacked America’s institutions, he also created the conditions for a course correction – Joe Biden’s victory.




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The CCP is a well-resourced and well-organised political force. It has the potential to be far more effective than any iconoclastic but capricious populist in permanently weakening the liberal foundations of the global order. Much of China’s influence abroad is unavoidable. A rising power with the economic and military strength that China wields is unlikely to be deterred.

On this logic, optimism has no place. But it would also be mistaken to adopt a fatalistic approach. Instead, Australia and its partners must focus their efforts on those elements of the liberal order most worth preserving and most under threat.

The centenary of the people’s republic is still 28 years away.The Conversation

Natasha Kassam, Fellow, ANU National Security College’s Futures Council, Australian National University and Darren Lim, Senior politics lecturer, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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